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WARRANTY REGISTRATION
Please Fill out and keep for your Records
Insert into envelope and return to Premier
First Name:_________________________ Last Name:____________________________
Address: ________________________________________ City: ____________________
State: _______________________________________ Zip Code: ___________________
Country: USA CANADA MEXICO OTHER ____________
Phone # ______-__________ -__________ Email Address: ______________________
Date of Purchase: ___________________ Date of Install: _______________________
Installed By: SELF Plumbing Professional Where Purchased: ____________
Model Number: _______________________ Serial Number: ____ - __________
Iowa Department of Public Health - Sales in Iowa require this to be completed, signed and returned.
These signatures will be retained on file for two years.
XXXXX
XXXXXX
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Premier
8716 W. Ludlow Dr. Suite #1
Peoria, AZ 85381
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